Job Summary: The person handling this position is responsible for coding, correcting, completing, and processing claims of all payer codes. He or She is also required to generate reports from computer in accordance with established procedures.
Job Duties:
1. Ensure completion of documentation and coding on the Route Slip and EMR when needed on charges entered in patient?s accounts for a correct and complete billing claim.
2. Reads and interprets patient medical information and applies correct ICD-9, ICD-10, CPT, and HCPCS codes
3. Researches documentation with physician and/or other medical personnel if clarification is required
4. Posting charges for both out-patient and in-patient facilities for multiple providers to assure accuracy of coding and patient accounts. Including following up with providers and putting together a complete file for accurate posting of charges.
5. Review all bundled procedures and services to assure higher payment from an insurance company based upon documentation in medical records by using two-digit modifiers.
6. Responsible for sending claims with correct coding to maximize payments to all private insurance, third party, workers? comp., hospital billing, CHDP, CHDP-TP, Medi-cal Managed Care, Family Planning Program on daily basis or as directed by the Billing Manager.
7. Communicate regularly to Senior MA, Clinical Coordinators and Providers to assure that route slips are completed, documentations complete, and submitted in accordance with procedure
8. All other related duties as directed by the Billing Manager.
Job Requirements:
1. Ability to work under pressure.
2. Ability to handle multi-functions.
3. Understanding of community based organizations.
4. Ability to demonstrate effective communication skills (verbal, nonverbal, written) with the medical/dental staff and Office Managers.
5. Ability to work proficiently and efficiently on a timely manner.
6. Ability to problem-solve and make decisions consistent with organizational policies and procedures
7. Able to work independently, demonstrating effective initiative, follow-through, organizational skills
8. Knowledge of all payer codes.
9. Knowledge of all programs offered by OFH.
10. Promotes and believes in OFH mission statement.
11. Ability to relate to the public regardless of ethnic, religion and economic status.
Additional Duties:
1. HIPAA compliance - Responsible for maintaining abreast of and in compliance with all H.I.P.A.A. regulations and requirements. Treats all member information confidential.
2. Compliance - Ensure compliance with all local, state and federal regulations.
3. QA/QI - Participate in QA/QI activities and contribute towards the overall performance improvement of the organization.
4. IT - Required to learn and use the EHR/EOHR (Medical Practice Electronic System) and its components. As required by the job functions and highlighted in the Policies and Procedures. These components include NextGen, Healthport, PMS, QSI and other electronic features, as they are developed and implemented, as applicable to work environment.
Qualifications, Education, and Experience:
1. High school graduate or GED with a minimum of two years experience in handling billing and account receivables in a similar set up or related field.
2. Must be CPC, CPCH, or CCS Certified with a minimum of 2 years of coding experience.
3. Maintains Coding Certification Credentials
4. Working knowledge of coding rules, regulations, and third party payer requirements
5. Must possess good customer service skills and professionalism to interact with staff, management, providers and patients.
All employees will participate in Patient Centered Health Home Model at Omni Family Health.
Responsible To: Billing Manager
Classification: Full or Part Time Position, Non-exempt
For an Application please visit www.omnifamilyhealth.org or email itagore@omnifamilyhealth.org.
Job Duties:
1. Ensure completion of documentation and coding on the Route Slip and EMR when needed on charges entered in patient?s accounts for a correct and complete billing claim.
2. Reads and interprets patient medical information and applies correct ICD-9, ICD-10, CPT, and HCPCS codes
3. Researches documentation with physician and/or other medical personnel if clarification is required
4. Posting charges for both out-patient and in-patient facilities for multiple providers to assure accuracy of coding and patient accounts. Including following up with providers and putting together a complete file for accurate posting of charges.
5. Review all bundled procedures and services to assure higher payment from an insurance company based upon documentation in medical records by using two-digit modifiers.
6. Responsible for sending claims with correct coding to maximize payments to all private insurance, third party, workers? comp., hospital billing, CHDP, CHDP-TP, Medi-cal Managed Care, Family Planning Program on daily basis or as directed by the Billing Manager.
7. Communicate regularly to Senior MA, Clinical Coordinators and Providers to assure that route slips are completed, documentations complete, and submitted in accordance with procedure
8. All other related duties as directed by the Billing Manager.
Job Requirements:
1. Ability to work under pressure.
2. Ability to handle multi-functions.
3. Understanding of community based organizations.
4. Ability to demonstrate effective communication skills (verbal, nonverbal, written) with the medical/dental staff and Office Managers.
5. Ability to work proficiently and efficiently on a timely manner.
6. Ability to problem-solve and make decisions consistent with organizational policies and procedures
7. Able to work independently, demonstrating effective initiative, follow-through, organizational skills
8. Knowledge of all payer codes.
9. Knowledge of all programs offered by OFH.
10. Promotes and believes in OFH mission statement.
11. Ability to relate to the public regardless of ethnic, religion and economic status.
Additional Duties:
1. HIPAA compliance - Responsible for maintaining abreast of and in compliance with all H.I.P.A.A. regulations and requirements. Treats all member information confidential.
2. Compliance - Ensure compliance with all local, state and federal regulations.
3. QA/QI - Participate in QA/QI activities and contribute towards the overall performance improvement of the organization.
4. IT - Required to learn and use the EHR/EOHR (Medical Practice Electronic System) and its components. As required by the job functions and highlighted in the Policies and Procedures. These components include NextGen, Healthport, PMS, QSI and other electronic features, as they are developed and implemented, as applicable to work environment.
Qualifications, Education, and Experience:
1. High school graduate or GED with a minimum of two years experience in handling billing and account receivables in a similar set up or related field.
2. Must be CPC, CPCH, or CCS Certified with a minimum of 2 years of coding experience.
3. Maintains Coding Certification Credentials
4. Working knowledge of coding rules, regulations, and third party payer requirements
5. Must possess good customer service skills and professionalism to interact with staff, management, providers and patients.
All employees will participate in Patient Centered Health Home Model at Omni Family Health.
Responsible To: Billing Manager
Classification: Full or Part Time Position, Non-exempt
For an Application please visit www.omnifamilyhealth.org or email itagore@omnifamilyhealth.org.